Cognitive Restructuring

Our thoughts can have a profound effect on our mood and physical state-including our perception of physical pain.

If you constantly tell yourself, "I don't see how this pain is ever going to get better," or "I can't take it anymore," as many pain patients do, you may exacerbate your pain in three ways.

1. It becomes hard to develop the sense of power and control necessary to fight the pain.
2. These self-defeating, stressful thoughts can further tense your muscles.
3. Such thoughts may alert the nervous system to widen the pain gate and increase the discomfort.

Cognitive restructuring revises the way you think about your problem by rewriting your internal "script." It has been successful in treating a number of psychological problems, most notably depression. In the treatment of chronic pain, cognitive restructuring is used as an
adjunct to other approaches, such as relaxation.

In cognitive restructuring, pain sufferers use a diary to record when their pain was particularly severe; what the situation was at the time of the pain; what they thought about and felt before, during, and after the pain episode; and what they tried to do to decrease the pain. By examining these diaries, perhaps with the help of a trained professional, the pain patient can identify negative thoughts and feelings and learn to change them. For example, they may learn to identify cues that trigger tension and anxiety and find out how to view stressful situations calmly and realistically rather than as catastrophes.